November 08, 2017

New Program Closes Gap in Addiction Treatment

A new program at Boston Medical Center's Grayken Center for Addiction is showing that connecting patients to addiction treatment when they are hospitalized for other conditions can be a powerful tool in closing a gap in addiction treatment. In fact, early results show that many of these patients continue treatment after they are discharged, underscoring the importance of reaching patients who might otherwise not get treatment for their addiction.

Approximately 17 percent of patients admitted at BMC have an active substance use disorder. This led providers to look for new ways to engage patients in addiction treatment when they were already here.

To accomplish this, they developed and implemented an inpatient addiction consult service, which is staffed by a multidisciplinary care team with expertise in treating addiction.

Ready for Treatment

"In order to help curb the epidemic, we need to take every opportunity to engage patients with substance use disorders and get them into treatment when they are ready," said study lead author Paul Trowbridge, MD, and graduate of BMC's addiction medicine fellowship. "This service will not only prove beneficial to patients, by helping them get access to evidenced-based treatment, but also to the health care system by reducing costs and readmissions."

Researchers found the initial results promising: Methadone treatment was initiated for 70 patients and 76 percent were linked to a methadone clinic upon discharge. Upon follow up, 54 percent were still receiving methadone at 30 days, 39 percent at 90 days, and 29 percent at 180 days.

Buprenorphine was initiated in 40 patients as a result of the consult, and 49 percent were linked to an outpatient clinic at discharge. Upon follow up, 39 percent were still engaged in treatment at 30 days, 27 percent at 90 days and 18 percent at 180 days.

Treating the Root Cause

"Like heart disease can cause a heart attack or a stroke, addiction causes many acute injuries requiring immediate attention, but we can't simply treat that issue without delving deeper to address the root cause," said Alex Walley, MD, MSc, a general internist at BMC's Grayken Center for Addiction who also oversees the addiction medicine fellowship. "Our goal is to engage willing patients in treatment and work with them on a plan that will keep them healthy and safe now and in the future."

The authors note that treatment is not one size fits all and that there is a need for additional treatment programs and services that meet the needs of even more patients both in the short and long term.

This study was published in the Journal of Substance Abuse Treatment.

Posted by Webmaster at 03:56 PM


November 05, 2017

Teen Alcohol and Marijuana Use Lessens Life Success

Young adults dependent on marijuana and alcohol are less likely to achieve adult life goals, according to new research by UConn Health scientists presented at the American Public Health Association 2017 Annual Meeting & Expo.

UConn Health researchers examined data from the Collaborative Study on the Genetics of Alcoholism (COGA) to track the effect teenage alcohol and marijuana use has on the achievement of life goals, defined as educational achievement, full time employment, marriage and social economic potential.

The study includes 1,165 young adults from across the United States whose habits were first assessed at age 12 and then at two-year intervals until they were between 25 and 34 years old. Most of the study participants had an alcoholic grandparent, parent, aunt or uncle.

Lower Economic Potential

Overall, individuals who were dependent on either marijuana or alcohol during their teen years achieved lower levels of education, were less likely to be employed full time, were less likely to get married and had lower social economic potential.

"This study found that chronic marijuana use in adolescence was negatively associated with achieving important developmental milestones in young adulthood. Awareness of marijuana's potentially deleterious effects will be important moving forward, given the current move in the US toward marijuana legalization for medicinal and possibly recreational use," said study author Elizabeth Harari.

Genders Affected Differently

The researchers also found that dependence may have a more severe effect on young men. Dependent young men achieved less across all four measures, while dependent women were less likely than non-dependent women to obtain a college degree and had lower social economic potential, but were equally likely to get married or obtain full time employment.

Previous research had shown that heavy use of alcohol or marijuana in adolescence affects people developmentally. This study followed up on that, to look at what happens after age 18. The life outcomes seem to show the differences are meaningful into adulthood.

The Research Continues

The study is ongoing.

"COGA investigators are following many subjects over the years and are using this extensive and growing database to examine several significant research topics," says Dr. Grace Chan, a statistician in the UConn Health department of psychiatry. Chan, Harari and UConn Health Alcohol Research Center Director Victor Hesselbrock are currently looking at whether there are different outcomes between young people dependent on alcohol versus marijuana, as well as why there were marked differences in outcomes between the sexes.

Posted by Webmaster at 11:35 PM